“Lansley’s white paper, the biggest shake-up for a decade, was due to be out next week but the timetable has slipped after Treasury officials said there was not enough provision for making GPs accountable to the public, given they would control 80% of the £100bn NHS budget.”

“The white paper got bounced back because there was no way the Treasury could sign up to a proposal which handed £80bn of public money to 35,000 GPs who are basically unaccountable private businesses,” said one official.”

Otherwise it could be the thin end of a wedge. Private businesses involved in providing care should all be accountable, each and every one of them, and that includes private care home providers. But they are not at present.